Euthanasia

John Key’s recent offhand comments on euthansia appropriately — if unwittingly — open the door to a critical national (and personal) discussion, regarding not only end-of-life choices for individuals, but the entire issue of end-of-life health care and spending.

Geoff Simmons, who co-authored the provocative Health Cheque with Gareth Morgan, develops the point in this excellent blog post.

Here are a few bits, but it’s well worth a read.

“What the PM talked about may not fit the narrow medical definition of euthanasia, but regardless he has rightly pointed the public debate toward a much bigger, and more important issue: how we deal with death given limited healthcare resources.”

“The real issue is that we only have limited resources – docs, nurses, hospital beds and money – to treat people. People always want more healthcare than we can deliver (particularly when its free!), so rationing occurs. We like to think we have a health system that can treat everyone all the time but this is an illusion. Treatments are rationed, and people die as a result. This is only a small step from euthanasia.”

“New Zealand wastes too much of our resources throwing the most expensive treatments at those already on death’s door. It is easy to see why, we naturally want to rescue those that are closest to death, but we shouldn’t kid ourselves that this spending actually makes us live longer. It just makes us feel better that we tried everything. But cleansing our conscience comes at a cost – as a country we can’t afford to prevent many of the diseases that eventually cause death. This one reason why poor people, particularly Maori and Pacific Islanders die earlier than the rest of us. As the PM has signalled, it is time for a more open, mature conversation about how health spending is rationed.”

“How we deal with the end of life is a controversial and incredibly expensive part of our public health care system. The latest estimate is that each person costs the health system more than $20,000 in their last year of life. That is an average figure, for some the cost runs in the hundreds of thousands of dollars. If we are really interested in living longer, we would spend more of this precious resource on prevention rather than heroically trying to keep people alive for a few more weeks or months.”

“We can all take action as individuals too. The truth is that all medical treatment has a downside, and often this sort of treatment simply prolongs the patients agony, or worse the treatment ends up being more damaging than the condition itself. In some cases, brave doctors, nurses, patients and families have an honest conversation about things, and decide that while treatment may be keeping the patient alive longer, [it] is causing unnecessary pain and is unlikely to restore a quality life. So treatment is ceased and the patient dies.”

“It is time to grow up, realise we aren’t immortal and start talking about a graceful death. The Government needs to own up to the fact that rationing already occurs, and we can do it better. As individuals we need to start talking openly about the downsides of treatment, and at what point we don’t wish to receive more treatment to keep us alive.”

BayBuzz magazine will be looking in more depth at these issues in editions to come. But meantime, if you haven’t seen it yet, to get warmed up, read Dr Tim Frendin’s recent BayBuzz article, Are We Ready For Old Age?

Tom Belford